In short, the joint disorder is fundamentally of _static or mechanical_ origin, and, this being so, the results of _anti-gouty_ treatment are open to a further misinterpretation. The victims, as we have said, exhibit very generally a tendency to _obesity_. Now, Ebstein and many others hold the view that _obesity and gout have affinities_. Ebstein, moreover, believes that treatment directed to the reduction of body weight will check the appearance of gouty arthritis or ameliorate the same when avowed. What happens is this: these corpulent subjects are placed on a special dietary. Hydrocarbon foodstuffs are limited, bread, amylaceous food and liquids being also restricted. Naturally, _pari passu_ with reduction in their body weight, their overburdened joints become more equal to their office. But those who assume that the chronic arthritis is of _gouty_ origin attribute, and, we think, wrongly, the beneficial results attained to correction of the underlying “gouty” habit. We prefer to subscribe to the simpler or mechanical theory, and in view of the widespread and, as we believe, erroneous belief in the gouty nature of this arthritis, we take the liberty of appending the salient features of these cases, while adding further a few remarks on the differential diagnosis of other symmetrical affections of the knees which may also be wrongly attributed to gout. CLINICAL SYMPTOMS OF VILLOUS SYNOVITIS The onset is gradual and insidious. Stiffness is the salient symptom, but sometimes the subject is more distressed by a sense of weakness, distension and unreliability. Pain is slight or absent, save when during walking pseudo-locking occurs. The mobility of the joints is usually unimpaired, and if any limitation exist it is the power of full extension that is usually restricted. Objectively the joint shows either general enlargement or swelling localised to the _supra_- or _infra-patellar_ regions. Intra-articular effusion which comes and goes is a very characteristic feature. On palpation a peculiar soft silken crepitus will be heard and felt as the patient alternately flexes and extends the limb. The enlarged fringes are also easily to be felt as knots or nodules which can be moved up or down on the underlying bone. The ease with which they can be appreciated depends upon the degree of effusion present at the time. Judging from their symptomatology, it seems probable that some of the cases included in Sir Dyce Duckworth’s category, chronic deforming gout, are of this description.